NHS Greater Glasgow Review of Acute Admissions

1. NHS Greater Glasgow Review of Acute Admissions Steering Group 23 September 2002

2. Outline of Presentation • Scope of the Project • Proposed Approach • Next Steps

3. Background • In many hospitals acute/general medicine is under intense pressure causing problems for the hospital as a whole • Many hospitals are responding with multiple initiatives to handle these pressures and problems • Underlying challenges are rarely addressed • A new approach is needed if this situation is to be resolved • NHS Greater Glasgow is facing these common problems, but in the context of major strategic change

4. Objectives of the Review • Produce an accurate forecast of future activity • Identify & implement systems/process changes to improve management of acute medical admissions in the short-term • Identify & implement systems/process changes to support the long-term reduction of acute receiving sites • Confirm the capacity & infrastructure required to accommodate acute admissions • Confirm the investment needed to provide the required capacity & infrastructure • Develop & implement a change management plan to support the development of new service models

5. Scope of the Project What works well elsewhere? What is the current position? What will work in Glasgow? New Model(s) of Care Resources Required Optimum Capacity Implementation Planning 5 Sites Short Term Long Term 3 Sites

6. Scope of the Project Build on GGHB work to date Practical examples What works well elsewhere? What is the current position? What will work in Glasgow? Core work of Project Team New Model(s) of Care Resources Required Optimum Capacity Workforce planning, costing, etc Implementation Planning Capacity modelling Short Term Long Term 5 Sites 3 Sites

7. Current Position Three-site long-term plans must be credible Existing pressure on staff & resources Stobhill GP GRI Home/ Intermediate Care etc A & E Patients Victoria SGH 5% rise per annum in acute admissions Ambulance Is bed blocking a problem? WI Significant pressures at all sites

8. New Models of Care – Short Term Do the 5 hospitals have the right capacity/staffing/systems? How to streamline/route referrals? Stobhill GP How to manage flows through departments? GRI Home/ Intermediate Care etc A & E Patients Victoria SGH Ambulance WI What’s the scope for more rapid discharges? How to make best use of new facilities?

9. New Models of Care – Long Term Do the 3 hospitals have the right capacity/staffing/systems? What’s the scope for reducing referrals? GP GRI Home/ Intermediate Care etc A & E Patients SGH What facilities/staffing/systems/etc are needed in the 2 departments? Ambulance Gartnavel (not A & E, ambulance) What’s the right capacity/location for intermediate care facilities? What are the alternatives to hospital admission?

10. Overview of Project Stage 1 Stage 1 Project Project Planning Planning Analysis of Analysis of Review of Review of Current Current Alternative Alternative Services Services Service Models Service Models Baseline Interim Assessment Assessment Stage 2 Stage 2 Stage 3 Stage 3 Short Short - - Term Term Long Long - - Term Term Service Service Strategic Strategic Planning Planning Planning Planning Change & Change & Change & Change & Implementation Implementation Implementation Implementation Programmes Programmes Programmes Programmes

11. Baseline Assessment Articulate Desired Service Principles Understand Current Processes & Resources Understand Facts About Patient Demand Understand Causes of Delays & Blockages Examples From Elsewhere Design New Model(s) of Service (Stage 2) Ideas From GG Stakeholders

12. Next Steps • Information collection & analysis: - patient activity, staffing, capacity, etc • Process mapping – visits from Secta team to each site • Meetings/interviews with key clinicians, managers & stakeholders • Service principles – draft statement to be shared with clinicians etc • Baseline assessment to be completed early November